Does a med spa have to register or hold a license in Maryland?

Short answer
The cited rules do not settle this — individuals need a cosmetology or limited esthetician license for esthetic services and a Board license to practice medicine; the Board's fee schedule lists shop licenses, but no cited rule says when a spa needs one.

An individual must be licensed by the Maryland Board of Cosmetologists before practicing cosmetology in the State, and esthetic services are carried on a limited license within that scheme. These claims reach the INDIVIDUAL cosmetology credential only; they do not address facility-level registration of a med spa, which is a separate question we do not answer here. On compounded drugs the Board of Pharmacy’s sterile compounding chapter supplies the definitions: compounding is the preparation, mixing, assembling, packaging or labeling of a drug as the result of a practitioner’s prescription drug order or practitioner/patient initiative, for research or teaching and not for sale or dispensing, or in anticipation of a prescription drug order based on routine, regularly observed prescribing patterns; a compounded sterile preparation is a sterile medication prepared in the pharmacy under accepted aseptic technique. Whether a compounded semaglutide or tirzepatide product may be supplied to or stocked by a med spa is not answered by these definitions. The COST of the credential is delegated rather than stated: the Board of Cosmetologists sets by regulation reasonable application, licensing, renewal, reinstatement, certification, permit and inspection fees, sized to approximate the cost of maintaining the Board, and publishes a schedule of them; examination fees may not exceed the cost of the examinations. The statute names no amount; the Board’s published schedule, read on the Board’s own page, lists a shop license (limited or full service) at $225 original and $56 renewal, and a cosmetologist or limited esthetician license at $28 original and $28 renewal, all nonrefundable and subject to change with public notice.